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  5. H.D. RODRIGUEZ, D.M.D., P.A.

H.D. RODRIGUEZ, D.M.D., P.A.

Company Details

Entity Name: H.D. RODRIGUEZ, D.M.D., P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 27 Dec 1999 (25 years ago)
Date of dissolution: 25 Sep 2020 (4 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 25 Sep 2020 (4 years ago)
Document Number: P00000001031
FEI/EIN Number 593613473
Address: 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 32763, US
Mail Address: 104 OVEROAKS PL., SANFORD, FL, 32771, US
ZIP code: 32763
County: Volusia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1982807889 2007-06-07 2022-07-21 104 OVEROAKS PL., SANFORD, FL, 327717118, US 1640 S VOLUSIA AVE, ORANGE CITY, FL, 327637335, US

Contacts
Phone +1 386-775-9559
Phone +1 386-775-4911

Authorized person
Name DR. HERMINIA D. RODRIGUEZ
Role PRESIDENT
Phone 3867754911

Taxonomy
Taxonomy Code 1223G0001X - General Practice Dentistry
License Number DN 10606
State FL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
H.D. RODRIGUEZ, D.M.D., P.A. 401(K) PROFIT SHARING PLAN 2015 593613473 2016-09-19 H.D. RODRIGUEZ, D.M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3867754911
Plan sponsor’s address 104 OVEROAKS PLACE, SANFORD, FL, 32771
H.D. RODRIGUEZ, D.M.D., P.A. 401(K) PROFIT SHARING PLAN 2015 593613473 2016-09-19 H.D. RODRIGUEZ, D.M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3867754911
Plan sponsor’s address 104 OVEROAKS PLACE, SANFORD, FL, 32771
H.D. RODRIGUEZ, D.M.D., P.A. 401(K) PROFIT SHARING PLAN 2014 593613473 2015-10-13 H.D. RODRIGUEZ, D.M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3867754911
Plan sponsor’s address 104 OVEROAKS PLACE, SANFORD, FL, 32771
H.D. RODRIGUEZ, D.M.D., P.A. 401(K) PROFIT SHARING PLAN 2013 593613473 2014-10-02 H.D. RODRIGUEZ, D.M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3867754911
Plan sponsor’s address 104 OVEROAKS PLACE, SANFORD, FL, 32771
H.D. RODRIGUEZ, D.M.D., P.A. 401(K) PROFIT SHARING PLAN 2012 593613473 2013-10-11 H.D. RODRIGUEZ, D.M.D., P.A. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3867754911
Plan sponsor’s address 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 327637335

Signature of
Role Plan administrator
Date 2013-10-11
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-11
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
H.D. RODRIGUEZ, D.M.D., P.A. 401(K) PROFIT SHARING PLAN 2011 593613473 2012-10-06 H.D. RODRIGUEZ, D.M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3867754911
Plan sponsor’s address 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 327637335

Plan administrator’s name and address
Administrator’s EIN 593613473
Plan administrator’s name H.D. RODRIGUEZ, D.M.D., P.A.
Plan administrator’s address 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 327637335
Administrator’s telephone number 3867754911

Signature of
Role Plan administrator
Date 2012-10-06
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-10-06
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
H.D. RODRIGUEZ, D.M.D., P.A. 401(K) PROFIT SHARING PLAN 2010 593613473 2011-10-13 H.D. RODRIGUEZ, D.M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3867754911
Plan sponsor’s address 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 327637335

Plan administrator’s name and address
Administrator’s EIN 593613473
Plan administrator’s name H.D. RODRIGUEZ, D.M.D., P.A.
Plan administrator’s address 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 327637335
Administrator’s telephone number 3867754911

Signature of
Role Plan administrator
Date 2011-10-13
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-13
Name of individual signing TATIANA POMBO
Valid signature Filed with authorized/valid electronic signature
H.D. RODRIGUEZ, D.M.D., P.A. 401(K) PROFIT SHARING PLAN 2009 593613473 2010-09-22 H.D. RODRIGUEZ, D.M.D., P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621210
Sponsor’s telephone number 3867754911
Plan sponsor’s address 104 OVEROAKS PLACE, SANFORD, FL, 32771

Plan administrator’s name and address
Administrator’s EIN 593613473
Plan administrator’s name H.D. RODRIGUEZ, D.M.D., P.A.
Plan administrator’s address 104 OVEROAKS PLACE, SANFORD, FL, 32771
Administrator’s telephone number 3867754911

Signature of
Role Plan administrator
Date 2010-09-22
Name of individual signing JULIE BURGESS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
RODRIGUEZ HERMINIA D Agent 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 32763

President

Name Role Address
RODRIGUEZ HERMINIA D President 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 32763

Secretary

Name Role Address
RODRIGUEZ HERMINIA D Secretary 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 32763

Treasurer

Name Role Address
RODRIGUEZ HERMINIA D Treasurer 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 32763

Director

Name Role Address
RODRIGUEZ HERMINIA D Director 1640 S. VOLUSIA AVE., ORANGE CITY, FL, 32763

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data
CHANGE OF PRINCIPAL ADDRESS 2009-03-22 1640 S. VOLUSIA AVE., ORANGE CITY, FL 32763 No data
CHANGE OF MAILING ADDRESS 2009-03-22 1640 S. VOLUSIA AVE., ORANGE CITY, FL 32763 No data
REGISTERED AGENT ADDRESS CHANGED 2009-03-22 1640 S. VOLUSIA AVE., ORANGE CITY, FL 32763 No data

Documents

Name Date
ANNUAL REPORT 2019-02-26
ANNUAL REPORT 2018-03-19
ANNUAL REPORT 2017-02-19
ANNUAL REPORT 2016-03-07
ANNUAL REPORT 2015-03-30
ANNUAL REPORT 2014-01-30
ANNUAL REPORT 2013-03-20
ANNUAL REPORT 2012-03-29
ANNUAL REPORT 2011-04-28
ANNUAL REPORT 2010-03-02

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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